All-in-One Lower Eyelid Reconstruction after Skin Malignancies Removal: Combined Modified Tenzel Flap {\&}amp$\mathsemicolon$ Palatal Mucosal Graft

Lower eyelid reconstruction for defects greater than 50% is a much discussed topic in literature. The aim of this paper is to present an “all-in-one” surgical technique based on the combination of modified Tenzel flap and palatal mucosal graft to restore the anatomical integrity. In our paper we present a case report of 64 years old patient admitted in Maxillo-Facial Surgery Unit of Polyclinic Federico II of Naples in January 2020. He was affected by lower eyelid basal cell carcinoma, measuring 1.5 cm in diameter. He was treated removing full-thickness neoplasia, leaving a surgical gap of 2 cm. Reconstruction was performed using modified Tenzel flap to cover the skin gap and a palatal graft for the reconstruction of the tarsal region structural integrity. This "all-in-one" technique can handle full thickness eyelid defects with the advantage of respecting the dual layer eyelid structure without the need of a secondary surgical step. Moreover, has shown excellent results for both the preservation of eyelid competency and the low complications rate like ectropion and lagophthalmos.